If You Have Further Questions Please Contact Cathy Mcavoy At: 360 725-2637 Or

If You Have Further Questions Please Contact Cathy Mcavoy At: 360 725-2637 Or

From: HCA Health Homes
Sent: Friday, February 20, 2015 8:55 AM
To: Leads
Subject: Health Home Tiers

Please find questions (and answers) from the “Goal Setting and Health Action Planning” training in Yakima and Kennewick for Health Home Care Coordinators in early February.

Please share this message with Care Coordinators within your agency and your contracted Care Coordination Organizations.

If you have further questions please contact Cathy McAvoy at: 360 725-2637 or

Questions related to the Patient Activation Measures (PAM), Caregiver Activation Measure (CAM), and Parent PAM (PPAM):

Question: If a client, parent, and/or caregiver refuse or decline the opportunity to complete the screening do we enter zero as the score?

Answer:No. The Health Action Plan (HAP) form (now dated August 2014) was revised and implemented effective October 1, 2014. Zero should not be entered when a client refuses or declines to complete a required screening because zero is a valid score. The HAP form now requires that the Care Coordinator enter a reason when a required screening is not completed. The Care Coordinator completes the HAP form by:

  • Entering the date that the PAM,CAM, or PPAM was declined by the client, parent, or caregiver
  • Entering the reason in the “if not complete, explain” field on the HAP
  • Leaving the score and level of activation fields blank, do not enter a zero (0)

The procedure is the same for all required screenings. Care coordinators should enter a reason and not a zero for the score when a client refuses or declines a required screening.

Question:If a client or collateral do not speak or read English do we forego administering the PAM, CAM, and/or PPAM and enter zero for the score?

Answer:No. The PAM, CAM, and PPAM have been translated by Insignia in a number of languages. To access translated copies of the screening tools visit the Insignia website. If the screening has not been translated for a specific language it is expected that the Care Coordinator will use a certified interpreter during the visit to administer the screening/s.

Questions related to the Pediatric Symptom Checklist – 17 (PSC-17):

Question: Does the Care Coordinator forego administering the PCS-17 for clients who do not speak English because it has not been validated for any other language than English?

Answer: No. The PSC-17 has been validated for a number of languages. Care Coordinators are expected to administer the screening when the translated screening is available. Visit the Massachusetts General Hospital website to access translated screening tools located at:

This website address is also included at the end of the instructions for the DSHS PSC-17 form 10-509. To access the form and instructions visit the DSHS Forms website located at:

If the PSC-17 is not available in a specific language the Care Coordinator must work with a certified interpreter to complete the assessment unless the parent or authorized representative decline or refuse to complete the assessment. For further information about interpreter services visit the HCA Interpreter Services website located at:

Question:If the client does not speak English or refuses to complete the assessment does the Care Coordinator just enter zero for the score?

Answer:No. If a client does not speak English access the appropriate translated screening tool at the Massachusetts General Hospital website and administer it to the parent or legal representative. If the PSC-17 is not available in a specific language the Care Coordinator must work with a certified interpreter to complete the assessment unless the parent or authorized representative decline or refuse to complete the assessment. If the parent or legal representative of the child decline or refuse to complete the assessment then enter the date the assessment was offered and enter the reason in the “if not complete, explain” field on the HAP. Do not enter zero (0) in the score field because zero is a valid score for this screening tool.

Question related to the Tiers:

Question:Is there information that can be referenced regarding the Health Home Tiers?

Answer:Yes. Two documents were developed for Care Coordinators to provide information about the Tiers and services provided for the three tier levels. Please find them attached. They are also located at the HCA Health Homes website located at:

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